Abstract
Problem statement: Thrombophilia has been recently implicated in earl y pregnancy loss and IVF implantation failure, by impairing the init ial vascularization process occurring at implantati on, which is necessary for a successful pregnancy. Approach: The aim of this study is to assess the presence possibility of mutation in thrombophilic g enes (Factor V (FV) gene, Prothrombin (PT) gene and Methylenetetrahydrofolate Reductase (MTHFR) gene) in women with repeated IVF-embryo transfer failure with unknown causes. The study was performed on patients with two or more previously failed IVF-embryo transfer cycles with u nknown causes. Women who conceived spontaneously with no previous history of miscarria ge and women who have had successful pregnancy after their first IVF-embryo transfer cycle are inc luded as control groups. Results: There are increase in allelic frequencies of thrombophilic genes (fact or V, prothrombin and methylenetetrahydrofolate reductase) mutation, in addition to genotype freque ncies (both homozygote and heterozygote) and increase in frequency of multiple gene mutations am ong women with IVF- embryo transfer failure. Conclusion: Thrombophilia has a significant role in IVF- embry o transfer implantation failure. Women with repeated IVF- embryo transfer failure should be screened for Thrombophilia to avoid repeated IVF- embryo transfer failure.
Highlights
In-Vitro Fertilization and Embryo Transfer (IVFET) is only one method of assisted reproduction that enables couples to turn their dream of having a child into a reality
Circumstantial factors that increase the risk of thrombosis include increasing age, immobilization, surgery, pregnancy, oral contraceptives, hormone replacement and inflammatory conditions (Dahlback, 2008)
Implantation failure, by impairing the initial vascularization process occurring at implantation, which is necessary for a successful pregnancy (Kujovich, 2004)
Summary
In-Vitro Fertilization and Embryo Transfer (IVFET) is only one method of assisted reproduction that enables couples to turn their dream of having a child into a reality. Several factors have been recognized to affect either success or failure rate of IVF-embryo transfer. Such factors include age, parity, previously successful pregnancy, basal hormonal levels, number of antral follicles before stimulation; endometrial thickness, embryo grading, position and length of uterus and technique of embryo transfer (Qublan et al, 2005). Inherited factors for thrombophilia include mutation in factor V Leiden, prothrombin and Methylenetetrahydrofolate Reductase (MTHFR) genes which are major causes of thromboembolic diseases. It may predispose for pregnancy complications with different mechanisms (Agnieszka et al, 2008).
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